新型胶原蛋白周转生物标志物在检测 MASLD 中肝脏硬度增加方面的性能。

IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Hannes Hegmar, Thomas Wiggers, Patrik Nasr, Johan Vessby, Stergios Kechagias, Nils Nyhlin, Hanns-Ulrich Marschall, Åsa Danielsson Borssén, Rickard Strandberg, Morten Karsdal, Diana Julie Leeming, Mattias Ekstedt, Hannes Hagström
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引用次数: 0

摘要

背景:胶原形成和降解的裂解产物有可能成为代谢功能障碍相关性脂肪性肝病(MASLD)患者晚期纤维化风险的一线生物标志物。在此,我们评估了 PRO-C3、PRO-C6、C4M、PRO-C18L 和临床评分 ADAPT(年龄、糖尿病、PRO-C3 和血小板计数)与纤维化-4 指数(FIB-4)相比在检测 LSM >8 kPa 或 >12 kPa 患者方面的性能:方法:采用基于酶联免疫吸附试验的方法对瑞典六所大学医院的 MASLD 患者(n = 269)的血清进行分析。采用振动控制瞬态弹性成像技术测量肝脏硬度(LSM)。采用曲线下面积(AUC)、校准曲线和净效益分析:结果:108 例(40.1%)患者的 LSM >8 kPa。PRO-C3、PRO-C6、C4M 和 PRO-C18L 的 AUC 在 0.48 至 0.62 之间。与FIB-4(0.71,95%CI = 0.64-0.77,p = 0.35)相比,ADAPT检测出>8 kPa患者的AUC最高(0.73,95%置信区间[CI] = 0.67-0.79),与FIB-4相比,从15%的概率阈值来看,ADAPT的净获益更高。FIB-4 和 ADAPT 在检测 LSM >12 kPa 的患者方面表现相当,AUC 为 0.76 对 0.76,p = 0.93:在识别 LSM >8 kPa 患者方面,ADAPT 似乎略优于 FIB-4。然而,ADAPT作为一线检测的临床实用性尚不确定,尤其是在低风险人群中。在检测 LSM >12 kPa 的患者方面,FIB-4 的总体性能与 ADAPT 相似。总之,这些结果表明,ADAPT 可能有助于检测 MASLD 早期纤维化阶段,但 FIB-4 仍是晚期纤维化的一线检测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Performance of novel collagen turnover biomarkers to detect increased liver stiffness in MASLD

Performance of novel collagen turnover biomarkers to detect increased liver stiffness in MASLD

Background

Cleavage products from collagen formation and degradation hold potential as first-line biomarkers for the risk of advanced fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we evaluated the performance of PRO-C3, PRO-C6, C4M, PRO-C18L, and the clinical score ADAPT (age, diabetes, PRO-C3, and platelet count) to detect patients with an LSM >8 kPa or >12 kPa in comparison to the Fibrosis-4 Index (FIB-4).

Methods

Serum from patients with MASLD (n = 269) from six Swedish University Hospitals was analyzed using enzyme-linked immunosorbent assay-based methods. Liver stiffness measurement (LSM) by vibration-controlled transient elastography was performed. The area under the curve (AUC), calibration curves, and net benefit analysis were used.

Results

An LSM >8 kPa was found in 108 (40.1%) patients. PRO-C3, PRO-C6, C4M, and PRO-C18L had AUCs ranging from 0.48 to 0.62. ADAPT had the highest AUC (0.73, 95% confidence interval [CI] = 0.67–0.79) to detect patients >8 kPa, compared to FIB-4 (0.71, (95%CI = 0.64–0.77, p = 0.35), and had a higher net benefit compared to FIB-4 from a probability threshold of 15%. FIB-4 and ADAPT performed equally well to detect patients with an LSM >12 kPa, AUC 0.76 versus 0.76, p = 0.93.

Conclusions

ADAPT seems to be marginally better than FIB-4 in identifying patients with an LSM >8 kPa. However, the clinical utility of ADAPT as a first line test is uncertain, especially in low-risk populations. The overall performance of FIB-4 was similar to that of ADAPT in detecting patients with an LSM of >12 kPa. Altogether, the results suggest that ADAPT might be useful to detect earlier stages of fibrosis in MASLD, but that FIB-4 remains a first-line test for advanced fibrosis.

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来源期刊
Journal of Internal Medicine
Journal of Internal Medicine 医学-医学:内科
CiteScore
22.00
自引率
0.90%
发文量
176
审稿时长
4-8 weeks
期刊介绍: JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.
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